No abstract available.
Free Tissue Flaps* ; Rectus Abdominis*

Traumatic loss of a finger in part or in which inevitably leads to significant functional deficit and a distortion in body image of the inflicted individual. The available reconstructive option in these circumstances have been toe to finger transfer using microsurgical technique, flap coverage after bone graft, and osteodistraction of the remnant finger. Each method carries advantages and drawbacks inherent in the technique, and generally requires long operative time and hospitalization. Furthermore, the postoperative results after such procedures can be said to be less satisfactory in aesthetic perspectives. Apart from the toe to finger transfer, not much can be sought in terms of functional recovery of the reconstructed part, For a long time finger prosthesis have been used as a replacement of the lost finger part, but it fails to deliver functional strength and tends to be dislodged rather easily. To overcome these shortcomings in the technique, an osseointegrated finger prosthesis has recently been devel-oped. Thumb, index and middle finger in 3 patients were reconstructed with this osseointegrated finger prosthesis. The procedure requires two procedures; the first stage involves placement of a titanium screw in the phalangeal or metacarpal bone proper, followed by fixation of an abutment onto the titanium screw 3 months after the primary operation. The skin surrounding the abutment is thinned out to minimize mobility of the prosthesis at this second stage of operation. After wound stabilization in 2-3 weeks, a custom-made silicone finger prosthesis is made and attached to the implanted abutment using super power magnets. The entire procedure requires 4 months up to the completion, but the procedures can be carried out on the outpatient basis under local anesthesia, not having to interfere with the daily activities of the patient. The aesthetic results with osseoperception have been found to be rewarding, and usual activity like a hand writing and typewriting have been possible. This alternative method could be used for finger reconstruction in cases of usual reconstructive surgery being impossible.
Anesthesia, Local ; Body Image ; Fingers* ; Hand ; Hospitalization ; Humans ; Operative Time ; Outpatients ; Prostheses and Implants* ; Reward ; Silicones ; Skin ; Thumb ; Titanium ; Toes ; Transplants ; Wounds and Injuries ; Writing

OBJECTIVE: To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in stroke patients, and to assess the difference in swallowing function between stroke patients with COPD (COPD group) and stroke patients without COPD (control group). METHODS: The subjects included 103 stroke patients. They underwent the pulmonary function test and were assigned to either the COPD group or the control group. Their penetration-aspiration scale (PAS) scores and functional dysphagia scale scores were compared by performing a videofluoroscopic swallowing study. The intergroup differences in lip closure, bolus formation, mastication, and the oral transit time, laryngeal elevation, cricopharyngeal dysfunction, oronasal regurgitation, residue in pyriform sinus and vallecula, pharyngeal transit time, aspiration, and esophageal relaxation were also compared. RESULTS: Thirty patients were diagnosed with COPD. The COPD group showed statistically higher PAS scores (4.67+/-2.15) compared to the control group (2.89+/-1.71). Moreover, aspiration occurred more frequently in the COPD group with statistical significance (p<0.05). The COPD group also showed higher occurrence of cricopharyngeal dysfunction, albeit without statistical significance. CONCLUSION: This study shows that a considerable number of stroke patients had COPD, and stroke patients with COPD had higher risk of aspiration than stroke patients without COPD.
Deglutition Disorders ; Deglutition* ; Humans ; Lip ; Mastication ; Prevalence ; Pulmonary Disease, Chronic Obstructive* ; Pyriform Sinus ; Relaxation ; Respiratory Aspiration ; Respiratory Function Tests ; Stroke*

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
Alveolar Process ; Axis, Cervical Vertebra ; Cadaver ; Head ; Humans ; Male ; Mandible ; Maxilla ; Tooth Cervix

OBJECTIVES: To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients' and caregivers' productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. RESULTS: A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. CONCLUSIONS: Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.
Adult ; Aged ; Aged, 80 and over ; Female ; *Health Care Costs ; *Health Expenditures ; Humans ; Insurance Claim Review ; Korea ; Male ; Middle Aged ; Prevalence ; Socioeconomic Factors ; Stroke/*economics ; Young Adult

Compared to cutaneous benign fibrous histiocytoma (BFH), deep-seated BFH is very rare and poorly recognized. Both cutaneous and deep-seated BFH are usually asymptomatic. We herein report a 25 year-old woman who presented with a painful mass in her foot that was poorly controlled by analgesics and associated with walking difficulty. After preoperative ultrasonographic evaluation, the mass was completely excised and histologic exam showed spindle cells loosely arranged in storiform architecture, with CD34-, desmin-, S-100-, focal CD68+, vimentin+, smooth muscle actin+, and factor XIIIa+. The patient was diagnosed with deep-seated BFH based on the histologic, radiologic and intraoperative findings.
Analgesics ; Female ; Foot ; Histiocytoma, Benign Fibrous ; Humans ; Muscle, Smooth ; Walking

Hemangioma of the scrotum is a rare and benign tumor and complete surgical excision is the preferred treatment. Magnetic resonance imaging (MRI) may be useful for the evaluation of these lesions particularly when determining the extent or depth of involvement would affect management decisions. Herein, we report 3 cases of scrotal hemangioma, and the usefulness of MRI in the evaluation of these lesions is discussed.
Hemangioma* ; Magnetic Resonance Imaging ; Scrotum*

Renal lipomas are among the rearest of renal tumors. They probably originate from fat cells within renal capsule or parenchyma. The tumors are confined within renal capsule, in contrast to the perirenal lipomas, which are extracapsular. We recently encountered a case of renal lipoma with bladder stone and diabetes mellitus in 61 years old male patient.
Adipocytes ; Diabetes Mellitus ; Humans ; Lipoma* ; Male ; Middle Aged ; Urinary Bladder Calculi

This study was conducted to measure the lead, cadmium and mercury levels in the scalp hair, cerebellum, cerebrum, heart, kidney, liver, lung, and spleen of the 60 Korean autopsy subjects and assess the relationship among those samples. The mean lead level in the scalp hair was 12.29+/-12.51 microgram/g and no significant difference was detected in lead concentrations between the two sexes. Among the internal organ tissues the cerebrum contained the highest level of lead. This is followed by the cerebellum, spleen and liver respectively. After which the kidney and lung showed a close similarity at relatively low concentrations and the heart contained the lowest concentration. There was also no significant variation found between sexes in a comparison of lead in the internal organ tissues. The concentrations of cadmium in kidney were 127.33+/-89.36 microgram/g and considerably higher than those in the other internal organs. The liver contained the next highest level of cadmium. In both sexes, the consistent difference was noted in the cadmium concentrations of the kidney, heart and spleen. Yet female cadmium level was higher than the male's. The concentrations of mercury in the kidney and liver were 1.26+/-2.89 microgram/g, 0.59+/-0.54 microgram/g and considerably higher than those in the other internal organs. The mean mercury level in the scalp hair was 1.29+/-0.64 microgram/g and no marked difference was noted in both sexes. The lead concentration in the spleen increased with advancing age, though not statistically significance, and most of the internal organ tissues that were examined showed no evidence of increased lead concentration with age. The kidney, cerebrum, spleen and cerebellum showed increased cadmium concentrations with age. Also as well as the internal organ tissues that were examined showed no evidence of increased mercury concentration with age. The lead concentrations in the liver and lung were higher in the urban area than in the rural area, but the lead concentration in the kidney was higher in the rural area. No difference was noted in tissue cadmium and mercury concentrations as to the area of residence either. The physical workers had greater concentrations of lead in cerebellum than did housewives or the unemployed. Yet no difference was noted in the other tissues between the two groups. In the cerebellum, cerebrum, heart, and spleen, the physical workers had greater concentrations of cadmium than students or mental workers. Also physical workers had greater concentrations of cadmium in lung than housewives or the unemployed. In contrast to lead and cadmium, both the housewives and the unemployed had higher concentrations of mercury in cerebellum and cerebrum than physical workers, but there was no difference was noted in the other tissues between the two groups. In the lead concentration, there was no statistically significant correlation between the scalp hair and examined internal organ tissues. There was a close relationship between lead levels in cerebellum and cerebrum (r=0.465, p<0.01), as well as a relationship between the cerebellum and the kidney(r=0.300, p<0.05). There was no statistically significant correlation between the cadmium levels in the scalp hair and in the examined internal organ tissues. Positive correlations were found between the cadmium concentrations in the cerebellum and the cerebrum(r=0.5543, p<0.01), heart(r=0.480, p<0.01), kidney(r=0.376, p<0.01) and spleen(r=0.408, p<0.01). Also positive correlation was found between in the cerebrum and the heart(r=0.377, p<0.01), kidney(r=0.484, p<0.01), liver(r=0.265, p<0.05), lung(r=0.458, p<0.01) and spleen (r=0.483, p<0.01). There was also no statistically significant correlation between the mercury levels in the scalp hair and in the examined internal organ tissues. Positive correlation was found between the mercury concentrations in the cerebellum and cerebrum(r=0.760, p<0.01), heart(r=0.270, p<0.05), liver(r=0.425, p<0.01), lung (r=0.488, p<0.01) and spleen (r=0.534, p<0.01), and also positive correlation was found between in the cerebrum and heart(r=0.376, p<0.01), liver(r=0.350, p<0.01), lung(r=0.554, p<0.01) and spleen (r=0.489, p<0.01). Various epidemiological studies reported usefulness and reliability of using scalp hair as a monitor of a environmental pollutants. In this study, there was statistically significant correlation of lead, cadmium and mercury levels in most of the tissues that were examined, but there was no statistically significant correlation between the lead, cadmium and mercury levels in the scalp hair and most of examined internal organ tissues. The findings of this study would suggest that it is still uncertain to using scalp hair as a biological monitoring.
Autopsy* ; Cadmium* ; Cerebellum* ; Cerebrum* ; Environmental Monitoring ; Environmental Pollutants ; Epidemiologic Studies ; Female ; Hair* ; Heart* ; Humans ; Kidney* ; Liver* ; Lung* ; Scalp* ; Spleen*

Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor that is usually found in women. Diagnosis of FNH mainly depends on imaging studies such as color Doppler flow imaging, computed tomography, and magnetic resonance imaging. It is characterized by the presence of stellate central scar and is nowadays incidentally diagnosed with increasing frequency due to advances in radiologic imaging technique. FNH typically presents as a single lesion in 70% of cases and generally does not progress to malignancy or recur after resection. Herein, we report a case of a young male patient with recurrent multiple FNH who underwent surgical resection for presumed hepatic adenoma on computed tomography.
Adenoma, Liver Cell/diagnosis/pathology ; Bile Ducts/pathology/surgery ; Contrast Media/diagnostic use ; Focal Nodular Hyperplasia/*diagnosis/pathology ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Magnetic Resonance Imaging ; Male ; Neoplasm Recurrence, Local ; Tomography, X-Ray Computed ; Young Adult